Published online Feb 20, 2016. doi: 10.5493/wjem.v6.i1.1
Peer-review started: October 3, 2015
First decision: October 27, 2015
Revised: January 6, 2016
Accepted: January 21, 2016
Article in press: January 22, 2016
Published online: February 20, 2016
Bone fracture occurs in stroke patients at different times during the recovery phase, prolonging recovery time and increasing medical costs. In this review, we discuss the potential risk factors for post-stroke bone fracture and preventive methods. Most post-stroke bone fractures occur in the lower extremities, indicating fragile bones are a risk factor. Motor changes, including posture, mobility, and balance post-stroke contribute to bone loss and thus increase risk of bone fracture. Bone mineral density is a useful indicator for bone resorption, useful to identify patients at risk of post-stroke bone fracture. Calcium supplementation was previously regarded as a useful treatment during physical rehabilitation. However, recent data suggests calcium supplementation has a negative impact on atherosclerotic conditions. Vitamin D intake may prevent osteoporosis and fractures in patients with stroke. Although drugs such as teriparatide show some benefits in preventing osteoporosis, additional clinical trials are needed to determine the most effective conditions for post-stroke applications.
Core tip: Post-stroke bone fracture negatively impacts stroke recovery, prolongs hospital stays, and increases economic cost. Stroke, osteoporosis and bone fracture share common risk factors. The main risk factors for post-stroke bone fracture include aging, osteoporosis, and loss of posture control. Bone mineral density measurement may identify patients who are at risk of post-stroke bone fracture. Drugs and supplements, such as vitamin D and teriparatide, can be tested in clinical settings for prevention of post-stroke bone fracture. Although bisphosphonate’s incur side effects, they are considered first-line drugs to prevent post-stroke bone fracture.